| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.76 | $45.76 | $58.12 | |
Aetna
| Professional | $45.76 | $45.76 | $48.17 | |
Emblem Health
| Professional | $38,249.62 | $38,249.62 | $38,249.62 | |
Martin's Point
| Facility | $45.76 | $45.76 | $58.12 | |
Martin's Point
| Professional | $45.76 | $45.76 | $58.12 |